Out of Hospital Chain of Survival
The 6 links in the adult out-of-hospital Chain of Survival are:
- Recognition of Cardiac Arrest and Activation of the emergency response system
- Early cardiopulmonary resuscitation (CPR) with an emphasis on chest compressions
- Rapid defibrillation
- Advanced resuscitation by Emergency Medical Services and other healthcare providers
- Post-cardiac arrest care
- Recovery including additional treatment, observation, rehabilitation, and psychological support.
Activation of Emergency Response
The first link, when an emergency occurs, call 999 immediately. If someone is unresponsive and is not breathing, send someone to call 999 and also send someone to retrieve an automated external defibrillator (AED).
High Quality CPR
The second link, dictates that CPR should commence immediately after a cardiac arrest has occurred. Call 999 if you don’t know how to perform CPR or ask someone help. If you are not trained in CPR, use hands-only CPR by pushing hard and fast on the center of the chest at a rate of 100-120 compressions per minute. The compression depth for adults should be at least two inches and the chest should recoil completely between compressions.
Defibrillation
The third link, the rescuer should place the AED device next to the victim once AED is available. Next, turn it on and follow the instructions for visual and audio prompts. Stand clear if a shock is advised and ensure that no one is in contact with the patient, then administer the shock. Continue to perform CPR until emergency personnel arrive.
Advanced Resuscitation
The fourth link, highly trained and equipped EMS personnel take over treatment, continuing to perform CPR, administering drugs, performing advanced airway procedures and other protocols prior to the patient’s admission to the advanced care facility.
Post-Cardiac Arrest
The fifth link, In-hospital or at another specialist healthcare facility, patients receive intensive post-SCA treatment.
Recovery
Last link, patients follow up for additional treatment, observation, rehabilitation, and psychological support.